PMID- 21521804
OWN - NLM
STAT- MEDLINE
DCOM- 20140204
LR  - 20120507
IS  - 1545-1097 (Print)
IS  - 1545-1097 (Linking)
VI  - 11
IP  - 3
DP  - 2012 May-Jun
TI  - The immune reconstitution inflammatory syndrome with tuberculosis: a common 
      problem in Ethiopian HIV-infected patients beginning antiretroviral therapy.
PG  - 198-202
LID - 10.1177/1545109711402212 [doi]
AB  - The Immune Reconstitution Inflammatory Syndrome (IRIS) in Ethiopian HIV-infected 
      patients coinfected with tuberculosis (TB) was studied. HIV-infected outpatients 
      initiating antiretroviral therapy (ART) at an HIV clinic in northern Ethiopia 
      from January 2007 through September 2008 were identified (n = 1977). Patients 
      with TB-IRIS occurring within 6 months of starting ART (n = 143) were compared 
      with a control group of patients with HIV who began ART but did not develop 
      TB-IRIS (n = 277). ART was not interrupted in any patient. Eleven (8%) patients 
      with TB-IRIS died. New or "unmasked" TB with accompanying IRIS occurred in 132 or 
      92% of the cases. Worsening or "paradoxical" TB (ie, already known to be present 
      and treated) was accompanied by IRIS in 11 (8%) patients. There was no 
      significant difference between "unmasked" and "paradoxical" cases with respect to 
      presentation of disease and outcome. Only a low baseline CD4 count (mean: 102 
      cells/muL) and a past history of World Health Organization (WHO) Clinical Stage 3 
      or 4 were associated with TB-IRIS (P < .05). The clinical manifestations of 
      TB-IRIS were diverse, requiring a high index of suspicion. For example, pleural 
      disease occurred in 13 patients, TB lymphadenitis in 17, intracranial TB in 9 
      patients, and disseminated TB in 15 patients. The majority of patients (88%) 
      responded to continuation of ART and TB therapy. Thus, TB-IRIS is common in 
      Ethiopian patients beginning ART, occurring in 7% of patients initiating 
      antiretroviral therapy.
FAU - Ali, Kedir
AU  - Ali K
AD  - 1Dessie Referral Hospital, Dessie, Ethiopia.
FAU - Klotz, Stephen A
AU  - Klotz SA
LA  - eng
PT  - Journal Article
DEP - 20110426
PL  - United States
TA  - J Int Assoc Physicians AIDS Care (Chic)
JT  - Journal of the International Association of Physicians in AIDS Care (Chicago, 
      Ill. : 2002)
JID - 101185740
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/complications/*immunology
MH  - Adolescent
MH  - Adult
MH  - Anti-HIV Agents/*adverse effects/therapeutic use
MH  - Antitubercular Agents/therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Case-Control Studies
MH  - Coinfection
MH  - Disease Progression
MH  - Ethiopia
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis/drug therapy/*immunology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Tuberculosis, Pulmonary/complications/diagnosis/*immunology
MH  - Young Adult
EDAT- 2011/04/28 06:00
MHDA- 2014/02/05 06:00
CRDT- 2011/04/28 06:00
PHST- 2011/04/28 06:00 [entrez]
PHST- 2011/04/28 06:00 [pubmed]
PHST- 2014/02/05 06:00 [medline]
AID - 1545109711402212 [pii]
AID - 10.1177/1545109711402212 [doi]
PST - ppublish
SO  - J Int Assoc Physicians AIDS Care (Chic). 2012 May-Jun;11(3):198-202. doi: 
      10.1177/1545109711402212. Epub 2011 Apr 26.